Provider Demographics
NPI:1609876622
Name:VILORIA, HOLLY MARIE (RN,MSN,FNP, PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:HOLLY
Middle Name:MARIE
Last Name:VILORIA
Suffix:
Gender:F
Credentials:RN,MSN,FNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32392 COAST HWY
Mailing Address - Street 2:STE. 250
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92651-6776
Mailing Address - Country:US
Mailing Address - Phone:949-488-2265
Mailing Address - Fax:949-499-2276
Practice Address - Street 1:32392 COAST HWY
Practice Address - Street 2:SUITE 190
Practice Address - City:LAGUNA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92651-6776
Practice Address - Country:US
Practice Address - Phone:949-499-2265
Practice Address - Fax:949-499-2276
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-01
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN 611913, NP14715363LP0808X, 363LF0000X, 364SM0705X
CARN611913163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364SM0705XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistMedical-Surgical
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health